Candida auris: An Overview of the Emerging Drug-Resistant Fungal Infection

Abstract

Candida auris is an invasive fungal pathogen that has been recognized globally as a serious health threat due to its extensive innate and acquired resistance to antifungal drugs. A growing number of emerging cases of C. auris have been reported with resistance to the standard antifungal treatments including azoles, echinocandins, and polyenes, making it difficult to treat. Unlike other Candida species, C. auris is challenging to diagnose using the standard laboratory methods and are typically prone to misidentification, resulting in inappropriate management. Consequently, C. auris infections have spread globally. The Centers for Disease Control and Prevention data showed that clinical cases of C. auris increased from 329 in 2018 to 1,012 in 2021. The incidence and prevalence of this invasive fungal infection are high in immunocompromised and hospitalized patients. Patients who had an organ transplant, are on immunosuppressive agents, are diabetic, recent antibiotic use, catheter use, and prolonged hospital or nursing homestays are vulnerable to C. auris infections. C. auris is rapidly spreading across healthcare settings globally and monitoring of its virulence as well as devising appropriate treatment approaches are thus highly required.

Keywords: Candida auris; Candidemia; Invasive fungal infection; Minimum inhibitory concentration; Multidrug-Resistant, Fungal.

Figure 1. Countries with reported Candida auris cases and clade identification by region and widespread distribution of C. auris.

Data reproduced from the Centers for Disease Control and Prevention, showing the worldwide distribution of C. auris as of February 15, 2021, and incorporating the four major genetic clades based on location: (I) South Asia Clade, (II) the East Asia Clade, (III) the South Africa Clade, and the (IV) South America Clade [520].

Figure 2. Candida auris infection control guidelines.

Summarized infection-control practices and recommendations [39]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958335/